Publications by authors named "Mullamitha S"

Cytoreductive surgery (CRS) is effective for colorectal cancer peritoneal metastases (CRPM) at increasing overall survival (OS) compared to systemic anticancer treatment (SACT) alone. The addition of Oxaliplatin heated intraperitoneal chemotherapy (HIPEC) has been shown in a randomized controlled trial to result in increased complications without significant OS benefit. This study evaluates outcomes for CRPM patients undergoing CRS+HIPEC with Oxaliplatin (Ox) 368mg/m (30 min), versus Mitomycin C (MMC) 35mg/m (90min).

View Article and Find Full Text PDF

PICO-SM was a prospective longitudinal study investigating the psychological impact of the COVID-19 pandemic on patients with colorectal cancer treated in a large UK tertiary cancer centre. Here, we present the impact of the third wave of the pandemic (December 2021 to February 2022), when the Omicron variant became prevalent in the UK, and the complete longitudinal comparison across the entire duration of this study. Patients were invited to complete a questionnaire, including screening psychometric tools.

View Article and Find Full Text PDF
Article Synopsis
  • Early onset colorectal cancer (EOCRC), affecting individuals under 50, has seen a significant rise in cases since 1970, with a notable increase from 2018-2019 to 2020-2021, highlighting a lack of data in the UK about this condition.
  • A study analyzing 203 EOCRC patients over 9 years revealed that most cases were sporadic, two-thirds had left-sided tumors, and many presented with metastatic disease, resulting in a median overall survival of 38 months and a median progression-free survival of 6 months.
  • The findings advocate for increased public awareness, earlier screening recommendations, and more extensive research to enhance understanding and management of EOCRC.
View Article and Find Full Text PDF

Treatment guidelines provided by PRODIGE-7 recommend perioperative systemic chemotherapy before cytoreductive surgery (CRS) for colorectal cancer peritoneal metastases (CRPM). Toxicity with multimodal treatment needs to be better defined. Chemotherapy response and impact on survival have not been reported.

View Article and Find Full Text PDF

Background: Appendix adenocarcinomas (AAs) are rare tumours that often present late, with a propensity for peritoneal metastases (PMs). This study aimed to evaluate outcomes of AA patients undergoing cytoreductive surgery (CRS) with curative intent and determine the role of systemic chemotherapy.

Materials And Methods: Data were collected from a prospective database and classified according to World Health Organization (WHO) 2019 classification.

View Article and Find Full Text PDF
Article Synopsis
  • This project developed a framework for managing patients with synchronous colorectal cancer and liver metastases, addressing terminology, diagnosis, and treatment strategies.* -
  • A multi-organizational consensus was reached through a Delphi process, resulting in twelve key statements with at least 70% agreement on issues like treatment pathways and tumor board composition.* -
  • Key findings include definitions for metastases timing, guidelines for clinical assessments, and recommendations for various treatment approaches, aimed at improving clinical practice for affected patients.*
View Article and Find Full Text PDF

Background: Contemporary management of patients with synchronous colorectal cancer and liver metastases is complex. The aim of this project was to provide a practical framework for care of patients with synchronous colorectal cancer and liver metastases, with a focus on terminology, diagnosis, and management.

Methods: This project was a multiorganizational, multidisciplinary consensus.

View Article and Find Full Text PDF

The COVID-19 pandemic has resulted in unprecedented changes to the lives of patients with cancer. To evaluate the impact of the COVID-19 pandemic on the mental health and well-being of patients with colorectal cancer, we conducted a prospective longitudinal questionnaire study at a UK tertiary cancer centre. In total, 216 participants were included: mean age 65 years, 57% ( = 122) male, 92% ( = 198) of white ethnicity.

View Article and Find Full Text PDF

Background: Since the beginning of the COVID-19 pandemic, multiple changes to the provision of cancer care has been introduced to maximize patient safety and protect staff. We aimed to identify factors influencing clinicians' decision on treatment modification during the initial phase of the pandemic, and to assess its impact on outcomes in patients with colorectal cancer.

Patients And Methods: Electronic records of patients seen in a large United Kingdom tertiary cancer center was reviewed.

View Article and Find Full Text PDF

Background: Patients with metastatic colorectal cancer are treated with cytotoxic chemotherapy supplemented by molecularly targeted therapies. There is a critical need to define biomarkers that can optimise the use of these therapies to maximise efficacy and avoid unnecessary toxicity. However, it is important to first define the changes in potential biomarkers following cytotoxic chemotherapy alone.

View Article and Find Full Text PDF

Background: The Coronavirus disease 2019 (COVID-19) pandemic has imposed significant changes in cancer service delivery resulting in increased anxiety and distress in both patients and clinicians. We aimed to investigate how these changes have been perceived by patients diagnosed with colorectal cancer and identify determinants of increased anxiety.

Patients And Methods: An anonymized 32-item survey in the specialized lower gastrointestinal cancer outpatient clinics at a tertiary cancer center in North West England between May 18 and July 1, 2020.

View Article and Find Full Text PDF

Background: The standard first- and second- line chemotherapy backbone regimens for metastatic colorectal cancer (mCRC) are 5-fluorouracil (5-FU)/capecitabine-based with addition of irinotecan or oxaliplatin. Until recently, evidence for optimal sequencing post second-line was sparse. Trifluridine/tipiracil (indicated for mCRC and gastric cancer after standard chemotherapies) was made available to UK patients via a named patient programme (NPP) before receiving marketing authorisation in Europe in 2016, allowing characterisation of UK treatment pathways, and evaluation of trifluridine/tipiracil in a UK non-trial population.

View Article and Find Full Text PDF

Background: The use of biomarkers to target anti-EGFR treatments for metastatic colorectal cancer (CRC) is well-established, requiring molecular analysis of primary or metastatic biopsies. We aim to review concordance between primary CRC and its metastatic sites.

Methods: A systematic review and meta-analysis of all published studies (1991-2018) reporting on biomarker concordance between primary CRC and its metastatic site(s) was undertaken according to PRISMA guidelines using several medical databases.

View Article and Find Full Text PDF

Oncological use of anti-angiogenic VEGF inhibitors has been limited by the lack of informative biomarkers. Previously we reported circulating Tie2 as a vascular response biomarker for bevacizumab-treated ovarian cancer patients. Using advanced MRI and circulating biomarkers we have extended these findings in metastatic colorectal cancer (n = 70).

View Article and Find Full Text PDF

We audited the accuracy of the Systemic Anti-Cancer Therapy dataset as a resource for rapid analysis of outcomes for patients, in this example, receiving Cancer Drug Fund funded monoclonal antibodies to treat metastatic colorectal cancer. We concluded that the Systemic Anti-Cancer Therapy dataset is a potentially valuable resource for rapidly determining survival outcome for patients treated with chemotherapy.

View Article and Find Full Text PDF

Up to a fifth of patients with colorectal cancer (CRC) present with synchronous hepatic metastases. In patients with CRC who present without intestinal obstruction or perforation and in whom comprehensive whole-body imaging confirms the absence of extrahepatic disease, evidence indicates a state of equipoise between several different management pathways, none of which has demonstrated superiority. Neoadjuvant systemic chemotherapy is advocated by current guidelines, but must be integrated with surgical management in order to remove the primary tumour and liver metastatic burden.

View Article and Find Full Text PDF

The development of personalised therapy and mechanism-targeted agents in oncology mandates the identification of the patient populations most likely to benefit from therapy. This paper discusses the increasing evidence as to the heterogeneity of the group of diseases called colorectal cancer. Differences in the aetiology and epidemiology of proximal and distal cancers are reflected in different clinical behaviour, histopathology, and molecular characteristics of these tumours.

View Article and Find Full Text PDF

Aims: Variants in UGT1A1 have previously been associated with toxicity from irinotecan chemotherapy. We conducted a pragmatic prospective cohort study to establish the relevance of UGT1A1 variants in the prediction of severe diarrhea and neutropenia in patients with colorectal cancer receiving irinotecan in a routine clinical setting.

Materials & Methods: Genotyping of UGT1A1*28 and c.

View Article and Find Full Text PDF

Purpose: Specific blocking of vascular endothelial growth factor receptor 2 (VEGFR-2) is a novel therapeutic approach. Here, we report the first phase I clinical trial evaluation of CDP791, a PEGylated di-Fab' conjugate that binds VEGFR-2.

Experimental Design: Cohorts of patients received CDP791 at doses between 0.

View Article and Find Full Text PDF

Purpose: A fully human monoclonal antibody to anti-alpha(v) integrins (CNTO 95) has been shown to inhibit angiogenesis and tumor growth in preclinical studies. We assessed the safety and pharmacokinetics of CNTO 95 in patients with advanced refractory solid tumors.

Experimental Design: In this phase I trial, CNTO 95 (0.

View Article and Find Full Text PDF

Aims: Ovarian cancer has a very poor prognosis, with 5-year survival rates of 5-20% for advanced-stage disease. This work was designed to verify whether the neoadjuvant approach had an effect on survival in patients with advanced-stage ovarian cancer.

Materials And Methods: Patients with stage III or IV disease who received neoadjuvant platinum-based chemotherapy (group 1) were compared with a group of conventionally treated patients (group 2).

View Article and Find Full Text PDF

Background: To study the effect of the interval between surgery and the start of chemotherapy in the treatment of patients with advanced ovarian cancer.

Methods: We stratified patients according to the start of platinum-based chemotherapy in group 1 (within 4 weeks from surgery), group 2 (between 4 and 8 weeks) and group 3 (between 8 and 12 weeks).

Results: Three hundred and ninty-four stage III ovarian cancer patients were analysed.

View Article and Find Full Text PDF

Endocrine therapy is a recognised option in the treatment of chemo-resistant ovarian cancer. We conducted a nonrandomised phase II evaluation of combination endocrine therapy with tamoxifen and goserelin in patients with advanced ovarian cancer that had recurred following chemotherapy. In total, 26 patients entered the study, of which 17 had platinum-resistant disease.

View Article and Find Full Text PDF

Purpose: CDP860 is an engineered Fab' fragment-polyethylene glycol conjugate, which binds to and blocks the activity of the beta-subunit of the platelet-derived growth factor receptor (PDGFR-beta). Studies in animals have suggested that PDGFR-beta inhibition reduces tumor interstitial fluid pressure, and thus increases the uptake of concomitantly administered drugs. The purpose of this study was to determine whether changes in tumor vascular parameters could be detected in humans, and to assess whether CDP860 would be likely to increase the uptake of a concurrently administered small molecule in future studies.

View Article and Find Full Text PDF

Fifty six human immunodeficiency virus (HIV) positive patients were studied and their serum lipid composition was compared with 35 HIV negative controls. Majority of the patients were in CDC group IV (66%) whereas 17.9% and 16.

View Article and Find Full Text PDF